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SAMHSA Survived

NYAPRS Note: As the following piece reports, the mid-December release of the congressional FY 2016 spending bill included both funding increases and level-funding of important programs and services administered by SAMHSA, including set aside to fund states’ work on early intervention for young people with first episode psychosis, criminal justice-related programs, Mental Health First Aid andthe Primary and Behavioral Health Care Integration Program.

It’s gratifying that funding to SAMHSA was increased despite unrelenting attacks Rep. Tim] Murphy and groups like the Treatment Advocacy Center in blaming problems within mental health systems on SAMHSA.

It’s time to stop using SAMHSA as a scapegoat and punching bag and to build on the historic advances it has helped states, localities and a broad range of mental health, addiction and healthcare treatment providers to implement in ways that have saved and supported hundreds of thousands of Americans struggling with the most serious conditions.

· The Role of Peers in a Mental Health/Substance Abuse Mobile Crisis Unit Intervention

· Talking About Hope, Suicide, and Suicide Stigma to Peers and Communities

· Developing Multicultural Peer Group Facilitators

· Strategies for Integrating Recovery Support Services in Programs for Justice-involved Consumers

· Voices from the African Diaspora

· Envisioning Alternatives to Suicide

· Federally Qualified Health Centers (FQHC) and Primary Care Settings

· Unique Approaches to Military Veterans’ Wellness and Reintegration

· The Path to Peer Crisis Respite

· Peer Support and Early Experiences of Psychosis

· Housing-Focused Outreach

· Veteran Specific Recovery Issues

· New Opportunities in Supportive Housing to Promote Recovery and Community Integration

· Aging Issues and Older Adult Consumers

· Frontier/Rural Peer Psychiatric Emergency Response Options

This tiresome focus on SAMHSA presents a dodge from looking more closely at the benefits of the ACA in advancing quality state and local level health and behavioral healthcare and to take on the false blame the NRA has laid on people with mental illness and the mental health system for gun violence, crucial remedies that Republicans like Mr. Murphy have sadly resisted taking on.

The mental health community is elated for the most part about funding increases and level-funding of key programs and services administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), including an increase in the mental health block grant and mental health research funding, following the release December 15 of the congressional FY 2016 spending bill.

The biggest news is that the congressional budget agreement calls for an increase of $50 million for the Community Mental Health Services block grant administered by SAMHSA. The proposal calls for 10 percent of those funds to be set aside, essentially doubling the amount states will receive for prevention and early intervention programs for young people with early psychosis.

The spending bill also calls for an increase of $1.5 million for the Criminal Justice/Mental Health Collaboration grants funded through the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) program administered by the U.S. Department of Justice. The program will be totally funded by $10 million in FY 2016. It provides grants to states and communities to support jail diversion, mental health courts, law enforcement training and community re-entry programs for people with mental illness and co-occurring substance use disorders who are involved with the criminal justice systems

(see story, page 6).

For the third consecutive year, Congress has provided $15 million for Mental Health First Aid Training, a public awareness and education program. “Mental Health First Aid has sparked a movement that is changing America’s culture,” Linda Rosenberg, president and CEO of the National Council for Behavioral Health, said in a statement.

“The training not only teaches people to recognize signs and symptoms of mental illnesses and addictions, but it gives them the confidence to intervene, the skills to safely de-escalate a crisis situation, and the information they need to help someone care for themselves or get professional help,” said Rosenberg. Since 2008, more than 500,000 Americans — from law enforcement officers to educators to bus drivers and many more — have been trained in Mental Health First Aid, according to Rosenberg.

Rosenberg added, “But we can’t stop here. With one in four Americans experiencing a mental health or addiction disorder each year, we are committed to making this important training as common as CPR.”

The budget is proposing $50 million for the Primary and Behavioral Health Care Integration Program (PBHCI). The president in his FY 2016 budget proposal requested $26 million. “The president had proposed shifting some of the funding for PBHCI into other SAMHSA priorities.” Rebecca Farley, director of policy and advocacy for the National Council, told MHW. “We’re grateful that Congress maintained the $50 million intact.”

The National Council is pleased with the increases for both the substance abuse and mental health block grants. “We’re very excited to see the $38.2 million increase for the Substance Abuse Prevention and Treatment block grant. It’s desperately needed in helping address the prevention, treatment and recovery needs we have in the U.S.,” Farley said.

Research

The budget proposal calls for an increase of $85.4 million in funding for biomedical and research services at the National Institute of Mental Health (NIMH). “This is by far the largest increase in mental health research since 2002,” Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness, told MHW. The $85 million is a portion of the $2 billion that the National Institutes of Health received overall in this proposal, said Sperling.

“We’re very pleased with the $50 million mental health block grant proposal,” said Sperling. “That’s doubling the size of the setaside for early psychosis programs. We want to make sure we take the lessons learned from the NIMH study and replicate it across the country.” The “tangible” outcomes have helped young people with education and employment efforts, said Sperling.

NIMH funded the Recovery After an Initial Schizophrenia Episode with coordinated specialty teams.

The legislation also provides $15 million for a new assisted outpatient treatment (AOT) pilot program through SAMHSA. “The AOT pilot is

promising,” noted Sperling. “It allows for communities to compete for funding and to do creative outreach and engagement.” The program is not compelling states to implement AOT programs if they don’t want to, he said.

The budget includes $1.6 billion for Housing and Urban Development. However, very little of the funding would go for new housing, added Sperling. Some funding will be provided toward the Veterans Affairs Supportive Housing program, he noted.

Some encouragement

The executive director of the New York Association of Psychiatric Rehabilitation Services (NYAPRS) said he is encouraged by the congressional agreement. “It’s gratifying that the SAMHSA budget was not severely impacted,” Harvey Rosenthal told MHW. The increase in the setaside funding for first-episode programs was long overdue, he said.

Rosenthal said he is discouraged about the negative attention leveled at SAMHSA, particularly in the mental health reform bill introduced by Rep. Tim Murphy (R-Pa.). The legislation, “Helping Families in Mental Health Crisis Act,” would replace SAMHSA with a new office headed by an assistant secretary at the U.S. Department of Health and Human Services.

“So many of the great reforms of the past 20 years were supported by SAMHSA,” said Rosenthal. “Congressman Murphy and some of his supporters have been unwilling to look at sweeping remedies contained in the state implementation of the ACA [Affordable Care Act],” he said. “SAMHSA has been under heavy attack. Murphy, the Treatment Advocacy Center, and other groups are blaming the problems on the mental health system on SAMHSA. We’re calling for an end to that. The focus on SAMHSA is a distraction and a way of not dealing with gun reform.”

Rosenthal added, “AOT is a false solution.” The funding, he said, should be put into the community for urgent care services for consumers with serious mental illness. “We never get to talk about how state Medicaid health care reform is the most sweeping and genuine way to make change. Change happens at the state level. Behavioral health is at the center of these reforms.”

Budget activities

Under the FY 2016 agreement, Project Awareness State Grants would receive $50 million, representing a $10 million increase over the president’s budget proposal, which was level to FY 2015.

In other budget activity, the National Strategy for Suicide Prevention would be funded at $2 million. The National Traumatic Stress Network would receive $46,887,000. Criminal and Juvenile Justice Programs would receive $4,269,000.

The National Council’s Farley said the organization is pleased about both the increases and the level-funding of mental health programs. “This is a very tight funding environment,” Farley said. “At every turn, Congress is trying to figure out how to cut spending. This is a real victory. We’re very thankful to Congress for recognizing the critical mental health and substance use needs that are facing the country.”